Local MRI Before and After Tumor Resection in Neuroblastoma: Impact of Residual Disease on Event Free Survival

Overview

Journal J Clin Med

Specialty General Medicine

Date 2023 Dec 9

PMID 38068349

Authors

Jurgen F Schafer

Sebastian Gassenmaier

Steven Warmann

Cristian Urla

Leonie Frauenfeld

Tim Flaadt

Maryanna Chaika

Michael Esser

Ilias Tsiflikas

Beate Timmermann

Jorg Fuchs

Affiliations

Soon will be listed here.

Abstract

(1) Background: The study aimed to investigate the influence of MRI-defined residual disease on local tumor control after resection of neuroblastic tumors in patients without routine adjuvant radiotherapy. (2) Methods: Patients, who underwent tumor resection between 2009 and 2019 and received a pre- and postoperative MRI, were included in this retrospective single-center study. Measurement of residual disease (RD) was performed using standardized criteria. Primary endpoint was the local or combined (local and metastatic) event free survival (EFS). (3) Results: Forty-one patients (20 female) with median age of 39 months were analyzed. Risk group analysis showed eleven low-, eight intermediate-, and twenty-two high-risk patients (LR, IR, HR). RD was found in 16 cases by MRI. A local or combined relapse or progression was found in nine patients of whom eight patients had RD ( = 0.0004). From the six patients with local or combined relapse in the HR group, five had RD ( = 0.005). Only one of 25 patients without RD had a local event. Mean EFS (month) was significantly higher if MRI showed no residual tumor (81 ± 5 vs. 43 ± 9; = 0.0014) for the total cohort and the HR subgroup (62 ± 7 vs. 31 ± 11; = 0.016). (4) Conclusions: In our series, evidence of residual tumor, detectable by MRI, was associated with insufficient local control, resulting in relapses or local progression in 50% of patients. Only one of the patients without residual tumor had a local relapse.

References

Peschmann A, Beer M, Ammann B, Dreyhaupt J, Kneer K, Beer A . Quantitative DWI predicts event-free survival in children with neuroblastic tumours: preliminary findings from a retrospective cohort study. Eur Radiol Exp. 2019; 3(1):6. PMC: 6353978. DOI: 10.1186/s41747-019-0087-4. View

Bar-Sever Z, Biassoni L, Shulkin B, Kong G, Hofman M, Lopci E . Guidelines on nuclear medicine imaging in neuroblastoma. Eur J Nucl Med Mol Imaging. 2018; 45(11):2009-2024. DOI: 10.1007/s00259-018-4070-8. View

Kushner B, Wolden S, LaQuaglia M, Kramer K, Verbel D, Heller G . Hyperfractionated low-dose radiotherapy for high-risk neuroblastoma after intensive chemotherapy and surgery. J Clin Oncol. 2001; 19(11):2821-8. DOI: 10.1200/JCO.2001.19.11.2821. View

Kannan S, Teo B, Solberg T, Hill-Kayser C . Organ motion in pediatric high-risk neuroblastoma patients using four-dimensional computed tomography. J Appl Clin Med Phys. 2017; 18(1):107-114. PMC: 5689899. DOI: 10.1002/acm2.12012. View

Yang D, Liu C, Gao J, Hu Q, Liang Y, Liu J . Association of image-defined risk factors with clinical features, tumor biology, and outcomes in neuroblastoma: a single-center retrospective study. Eur J Pediatr. 2023; 182(5):2189-2196. DOI: 10.1007/s00431-023-04899-0. View

Hassan H, Bessar M, Herzallah I, Laury A, Arnaout M, Basha M . Diagnostic value of early postoperative MRI and diffusion-weighted imaging following trans-sphenoidal resection of non-functioning pituitary macroadenomas. Clin Radiol. 2018; 73(6):535-541. DOI: 10.1016/j.crad.2017.12.007. View

Maric I, Weber M, Prochnow A, Schmitz J, Unger N, Schaarschmidt B . Efficacy and Safety of I-MIBG Dosimetry-Guided High-Activity I-MIBG Therapy of Advanced Pheochromocytoma or Neuroblastoma. J Nucl Med. 2023; 64(6):885-891. DOI: 10.2967/jnumed.122.264775. View

Lucas Jr J, McCarville M, Cooper D, Doubrovin M, Wakefield D, Santiago T . Implications of Image-Defined Risk Factors and Primary-Site Response on Local Control and Radiation Treatment Delivery in the Management of High-Risk Neuroblastoma: Is There a Role for De-escalation of Adjuvant Primary-Site Radiation Therapy?. Int J Radiat Oncol Biol Phys. 2018; 103(4):869-877. PMC: 8810202. DOI: 10.1016/j.ijrobp.2018.11.041. View

Ganau M, Foroni R, Gerosa M, Ricciardi G, Longhi M, Nicolato A . Radiosurgical options in neuro-oncology: a review on current tenets and future opportunities. Part II: adjuvant radiobiological tools. Tumori. 2015; 101(1):57-63. DOI: 10.5301/tj.5000215. View

10.

Olesrud I, Schulz M, Marcovic L, Kristensen B, Pedersen C, Kristiansen C . Early postoperative MRI after resection of brain metastases-complete tumour resection associated with prolonged survival. Acta Neurochir (Wien). 2019; 161(3):555-565. DOI: 10.1007/s00701-019-03829-0. View

11.

Robbins J, Krasin M, Pai Panandiker A, Watkins A, Wu J, Santana V . Radiation therapy as part of local control of metastatic neuroblastoma: the St Jude Children's Research Hospital experience. J Pediatr Surg. 2010; 45(4):678-86. PMC: 2897834. DOI: 10.1016/j.jpedsurg.2009.11.003. View

12.

Gatcombe H, Marcus Jr R, Katzenstein H, Tighiouart M, Esiashvili N . Excellent local control from radiation therapy for high-risk neuroblastoma. Int J Radiat Oncol Biol Phys. 2009; 74(5):1549-54. DOI: 10.1016/j.ijrobp.2008.10.069. View

13.

Gassenmaier S, Tsiflikas I, Maennlin S, Urla C, Warmann S, Schaefer J . Retrospective accuracy analysis of MRI based lesion size measurement in neuroblastic tumors: which sequence should we choose?. BMC Med Imaging. 2020; 20(1):105. PMC: 7487996. DOI: 10.1186/s12880-020-00503-1. View

14.

Maris J . Recent advances in neuroblastoma. N Engl J Med. 2010; 362(23):2202-11. PMC: 3306838. DOI: 10.1056/NEJMra0804577. View

15.

Applebaum M, Henderson T, Lee S, Pinto N, Volchenboum S, Cohn S . Second malignancies in patients with neuroblastoma: the effects of risk-based therapy. Pediatr Blood Cancer. 2014; 62(1):128-33. PMC: 4237647. DOI: 10.1002/pbc.25249. View

16.

Orsatti G, Morosi C, Giraudo C, Varotto A, Crimi F, Bonzini M . Pediatric Rhabdomyosarcomas: Three-Dimensional Radiological Assessments after Induction Chemotherapy Predict Survival Better than One-Dimensional and Two-Dimensional Measurements. Cancers (Basel). 2020; 12(12). PMC: 7766999. DOI: 10.3390/cancers12123808. View

17.

Jazmati D, Brualla L, Littooij A, Webber B, Dieckmann K, Janssens G . Overcoming inter-observer planning variability in target volume contouring and dose planning for high-risk neuroblastoma - a European multicenter effort of the SIOPEN radiotherapy committee. Radiother Oncol. 2023; 181:109464. DOI: 10.1016/j.radonc.2023.109464. View

18.

Park J, Bagatell R, Cohn S, Pearson A, Villablanca J, Berthold F . Revisions to the International Neuroblastoma Response Criteria: A Consensus Statement From the National Cancer Institute Clinical Trials Planning Meeting. J Clin Oncol. 2017; 35(22):2580-2587. PMC: 5676955. DOI: 10.1200/JCO.2016.72.0177. View

19.

Chen A, Trout A, Towbin A . A review of neuroblastoma image-defined risk factors on magnetic resonance imaging. Pediatr Radiol. 2018; 48(9):1337-1347. DOI: 10.1007/s00247-018-4117-9. View

20.

Trout A, Towbin A, Klingbeil L, Weiss B, von Allmen D . Single and multidimensional measurements underestimate neuroblastoma response to therapy. Pediatr Blood Cancer. 2016; 64(1):18-24. DOI: 10.1002/pbc.26159. View